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Daniel Harney - Form 460 - 2017/07/01 - 2017/12/31Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 07/01/2017 through 12/31/2017 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee • Sponsored ❑ Primarily Formed Candidate/ • Small Contributor Committee Officeholder Committee • Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER 1386442 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Harney for Council 2018 STREETADDRESS (NO P.O. BOX) MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX/ E -MAIL ADDRESS COVER PAGE ttate Stamp - ' RE��1y � w Date of election if applic Page of (Month, Day, Year) 1� R�S ��F�CE For Official Use Only GILROY, CA V 2. Type of Statement: 10 Preelection Statement ❑ Quarterly Statement ❑ Semi - annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Joan M Lewis MAILING ADDRESS NAME OF ASSISTANT TREASURER, IF ANY MAILINGADDRESS CITY STATE ZIP CODE AREA CODE /PHONE OPTIONAL: FAX /E -MAIL ADDRESS joaniemlewis @charter. net 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on h� / 4 a w Data Executed on 1 L - - Date Executed on Date Executed on Date By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent By Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Daniel Harney OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP 7351 Rosanna street Gilroy, CA 95020 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 CALIFORNIA TORM Page of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate /Officeholder Committee Listnamesof officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR'CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page to whole dollars. Statement covers period - 07/01/2017 from through 12/31/2017 Page of SEE INSTRUCTIONS ON REVERSE _ NAME OF FILER I.D. NUMBER Harney for Council 2016 1386442 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 7749.00 1. Monetary Contributions .................... ............................... schedule A, Line 3 $ $ 1/1 through 6/30 7/1 to Date 1950.00 2. Loans Received .... ............................... ............................. Schedule B, Line 3 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ Received $ $ 4. Nonmonetary Contributions ............. ............................... Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........ ............................Add Lines 3 +4 $ $ 8699.00 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made ................................. ............................... Schedule E, Line 4 $ $ 5309.56 Candidates 7. Loans Made ........................................ ............................... Schedule H, Line 3 5309.56 22. Cumulative Expenditures Made* 8. SUBTOTAL CASH PAYMENTS ........... ............................... Add Lines 6 + 7 $ $ (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) ........... ............................... Schedule F Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment .......................... ............................... Schedule C, Line 3 (mm /dd /yy) 11. TOTAL EXPENDITURES MADE ......... ............................... Add Lines s + 9 + 10 $ $ 5309.56 $ $ Current Cash Statement 12. Beginning Cash Balance ..... ....................... Previous summary Page, Line 16 $ 3389.44 To calculate Column B, 13. Cash Receipts ............................ ............................... Column A, Line 3 above add amounts in Column A to the corresponding *Amounts in this section may be different from amounts 14. Miscellaneous Increases to Cash ... ............................... Schedule 1, Line 4 amounts from Column B reported in Column B. 15. Cash Payments .......................... ............................... Column A, Line s above of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 3364.21 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED . ............................... Schedule B, Part 2 $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts an y). 18. Cash Equivalents ................. ............................... See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov SCHEDULE B - PART 1 Schedule B — Part 1 to whole dollars. Statement covers period Loans Received 07/01/2017 so= from through 12/31/2017 page_ SEE INSTRUCTIONS ON REVERSE of NAME OF FILER I.D. NUMBER Harney for Council 2016 1386442 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OUTSTANDING BALANCE AMOUNT AMOUNT PAID OUTSTANDING BALANCE AT INTEREST ORIGINAL 9 CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN OF THIS PAID THIS PERIOD AMOUNT OF LOAN CONTRIBUTIONS TO DATE NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD Daniel Harney Manager, ❑ PAID CALENDAR YEAR eBay inc, $ $ 1000 0 % $ 1000 $ 1000 PER ELECTION** [] FORGIVEN RATE $ 0 $ 1000 $ $ 08/05/16 $ DATE DUE t1Z IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR Daniel Harney Manager, eBay inc. $ $ 950 0 % $ 950.00 $ 1950 El FORGIVEN FORGIVEN PER ELECTION" $ $ 950 $ $ 06/3016 $ DATE DUE TO IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR PER ELECTION'" ❑ FORGIVEN RATE DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC I SUBTOTALS $ 1950$ $ 1950 Schedule B Summary 1. Loans received this period ...................................................................................... ..............................$ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ........................................................................... ..............................$ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................... ............................... NET $ Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov